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Plasminogen Activator Inhibitor-1 and Diagnosis of the Metabolic Syndrome in a West African Population

Kodaman, N; Aldrich, MC; Sobota, R; Asselbergs, FW; Brown, NJ; Moore, JH; Williams, SM; (2016) Plasminogen Activator Inhibitor-1 and Diagnosis of the Metabolic Syndrome in a West African Population. Journal of the American Heart Association , 5 (10) 10.1161/JAHA.116.003867. Green open access

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Abstract

Background Metabolic syndrome (MetS) is diagnosed by the presence of at least 3 of the following: obesity, hypertension, hyperglycemia, hypertriglyceridemia, and low high‐density lipoprotein. Individuals with MetS also typically have elevated plasma levels of the antifibrinolytic factor, plasminogen activator inhibitor‐1 (PAI‐1), but the relationships between PAI‐1 and MetS diagnostic criteria are not clear. Understanding these relationships can elucidate the relevance of MetS to cardiovascular disease risk, because PAI‐1 is associated with ischemic events and directly involved in thrombosis. Methods and Results In a cross‐sectional analysis of 2220 Ghanaian men and women from urban and rural locales, we found the age‐standardized prevalence of MetS to be as high as 21.4% (urban women). PAI‐1 level increased exponentially as the number of diagnostic criteria increased linearly (P<10−13), supporting the conclusion that MetS components have a joint effect that is stronger than their additive contributions. Body mass index, triglycerides, and fasting glucose were more strongly correlated with PAI‐1 than with canonical MetS criteria, and this pattern did not change when pair‐wise correlations were conditioned on all other risk factors, supporting an independent role for PAI‐1 in MetS. Finally, whereas the correlations between conventional risk factors did not vary significantly by sex or across urban and rural environments, correlations with PAI‐1 were generally stronger among urban participants. Conclusions MetS prevalence in the West African population we studied was comparable to that of the industrialized West. PAI‐1 may serve as a key link between MetS, as currently defined, and the endpoints with which it is associated. Whether this association is generalizable will require follow‐up.

Type: Article
Title: Plasminogen Activator Inhibitor-1 and Diagnosis of the Metabolic Syndrome in a West African Population
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/JAHA.116.003867
Publisher version: http://dx.doi.org/10.1161/JAHA.116.003867
Language: English
Additional information: © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Keywords: Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, diabetes mellitus, epidemiology, fibrinolysis, hypertension, lipids, obesity, VISCERAL ADIPOSE-TISSUE, CORONARY-HEART-DISEASE, INSULIN-RESISTANCE, CARDIOVASCULAR-DISEASE, CORRELATION-COEFFICIENT, FAT DISTRIBUTION, PLASMA PAI-1, RISK-FACTORS, OBESITY, TYPE-1
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/1526817
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